About the Lifetime Achievement Award
The Society of University Surgeons (SUS) has awarded the 2023 SUS Lifetime Achievement Award to Timothy R. Billiar, MD, the George Vance Foster Professor and Chair, Department of Surgery, Associate Senior Vice Chancellor for Clinical Academics, University of Pittsburgh, Executive Vice President, and Chief Scientific Officer of University of Pittsburgh Medical Center (UPMC). Dr. Billiar will be presented with the Lifetime Achievement Award on Tuesday, February 6, 2024, at the 19th Annual Academic Surgical Congress (ASC) in Washington, DC.
The Society of University Surgeons initiated the Lifetime Achievement Award (LTAA) in 2005. This award was designed to recognize individuals who have had a sustained career in academic surgery with contributions to surgical science. In addition, these individuals have demonstrated a commitment to the Society of University Surgeons, whereby they have participated in the Society even after superannuating to Senior Membership status. Their participation in the Society is evidenced by the attendance of the meetings yearly and active participation in discussion of papers, attendance of the banquets, society functions, and mentoring the next generation of leaders in the society.
The Society of University Surgeons seeks to honor and recognize these individuals because of their embodiment of the principles of the Society. We seek to recognize these individuals to establish role models for younger generations of surgeons to honor and emulate their contributions to the science of surgery, and moreover to the Society of University Surgeons.
Dr. Billiar was nominated and selected based on his exceptional leadership, contributions to academic surgery, and strong support of the SUS. The SUS appreciates Dr. Billiar’s many years of service to the SUS, including his tenure as President in 2001. Amongst his impressive accomplishments are his 35 years of continuous NIH Funding, over 900 peer-reviewed papers, an H-Index of 161, nine patents, and service on numerous NIH study sections. Notable amongst his scientific contributions are the initial description and cloning of the human inducible nitric oxide synthase gene, fundamental discoveries on the functions of nitric oxide in biological systems, investigations into immune activation mechanisms in trauma/sterile injury with a focus on DAMP-PRR interactions, and large-scale omics studies on the human response to injury. For these contributions and others, Dr. Billiar received the Medallion for Scientific Achievement from the American Surgical Association, Distinguished Service Award-University of Chicago, and the Scientific Achievement Award from the Shock Society. Additionally, he has trained three decades of General Surgery residents, many of whom have gone on to hold leadership positions in Academic Surgery. His remarkable 25-year tenure as Chair of the Department of Surgery at the University of Pittsburgh has further solidified his impact. Under his leadership, the University of Pittsburgh Department of Surgery has been a long-standing institutional donor to the Academic Surgical Congress. Furthermore, Dr. Billiar’s steadfast commitment to the SUS is evident through his continuous support of the ASC and mentorship of numerous past SUS Presidents. As a passionate educator, he served on the Surgery Residency Review Committee of the ACGME from 2008 to 2014 and has co-edited the last four editions of Schwartz’s Textbook of Surgery. The SUS is honored to recognize Dr. Billiar’s immense contributions to the field of academic surgery with the LTAA.
Holding Hook Since I was Six Years Old
Dr. Billiar credits his parents for his interest in medicine. He grew up in a small town in Nebraska, where his dad was a veterinarian who had his own clinic. From an early age, he worked at the clinic, including assisting his dad with surgery. He likes to say, “I have been holding hook since I was 6 years old.” These real-life lessons in living physiology and anatomy spawned a life-long passion and curiosity for the workings of the human body and mechanisms of disease. Dr. Billiar’s dad, or “Doc Bob” as he was known to the locals, passion for animals and veterinary medicine was palpable; he worked at it 7 days a week for 57 years before semi-retiring at age 83. These experiences with his dad were balanced by his mother, a nurse who worked most of her career in skilled nursing facilities and nursing homes. He remembers her for the depth of her empathy and her passion for giving a voice to those institutionalized patients that could not speak for themselves. Through her, he worked for several years as a nurse’s aid and orderly, and learned that no task was too small or insignificant when it came to helping those in need. He also learned the rewards of serving others and he committed in high school to a career in medicine. However, Dr. Billiar notes that his parents were far from unidimensional as role models. As an example, they were both dedicated and life-long artists who expressed themselves through their paintings and other works.
I Have an Innate Curiosity
When asked about his interests and what set him on the path to acute care and trauma as an academic surgeon, Dr. Billiar stated, “I have an innate curiosity, and I have always really wanted to know how things work, how you make discoveries, and add new knowledge.“ The love of science is a big part of his background, as well as the idea that one could put that into action by mastering the scientific method. He involved himself in research as an undergraduate student, spent a summer in a biochemistry lab and sought research opportunities in medical school. At the University of Chicago, Dr. Billiar’s long time mentor and friend, Dr. Wolfgang Schraut, gave him an opportunity to help run his lab as a medical student. He presented that work on bowel transplantation at the SUS (residents meeting) and AAS. He feels blessed to have matched at the University of Minnesota for residency. It was, and still is, one of the preeminent places for the training of surgeon scientists, and they had created a PhD in surgery. While he went to Minnesota to become a transplant surgeon (or so he thought at first), he encountered Dr. Frank Cerra, a leading thinker in the area of surgical critical care early in residency. That sparked an interest in the pathophysiology of acute critical illness. He started in the lab working with Richard Simmons, MD, and also Cerra in 1986 and picked up a project that Dr. Michaela West had started on the mechanisms of organ dysfunction during sepsis. Dr. West provided a great deal of guidance early on and she has remained a life-long friend and colleague. Dr. Billiar moved with Dr. Simmons to Pitt in 1987, and working together they made some early discoveries in the nitric oxide field as it first broke as a major scientific story. Getting into a hot field of science with the support excellent mentors and making some discoveries really catapulted Dr. Billiar’s career early on. In the end, it was his scientific interest that drove his decision to pursue trauma/ critical care as a clinical focus. It also did not hurt that trauma provided the time flexibility needed to build and maintain a long-term research emphasis.
Continuous Immersion in Science
Staying NIH funded has come from staying immersed in and current with science. Every year, Dr. Billiar attends at least two basic science meetings, such as a Gordon Conference or Keystone Symposia, and just listens to science nonstop for 3-4 days. He explains there’s nothing like sitting in a room with a hundred other scientists and listening to the presentations, scientific discussions, while making contacts and meeting potential collaborators. While often the only surgeon in the room, the novel perspective he provides as a surgeon often captures the interest of other attendees. The continuous immersion in science through meetings and participating in the peer review process via study sections, program reviews and paper reviews, fuels creativity and novel science. He stated “I have often said, I could probably be professionally happy without all the other things I do, but if you take research and the dynamics of being a scientist away, I would not be professionally satisfied.”
Menteeship is Really a Thing
Dr. Billiar readily points to the great mentors and role models in Surgery he has encountered along his career path. Dr. David Skinner was Chair of Surgery at the University of Chicago. He had assembled a phenomenal faculty and stayed personally involved in medical student education. He made surgery an easy choice. Likewise, Dr. John Najarian as Chair at the University of Minnesota oversaw a remarkable faculty that included many surgeon-scientists. It was in this environment fertile in surgical science that he met Dr. Simmons (past president of the SUS and LTAA recipient), the most influential mentor of his career. Dr. Billiar flourished under his mentorship where they both shared a passion for scientific breakthroughs. Dr. Simmons’ capacity for abstract thinking and seeing something different in the data than all the others is something to behold. Dr. Billiar states that he still listens intently to what Dr. Simmons has to say in their weekly “Simmons Conference” at the University of Pittsburgh. It was also an easy choice to follow Dr. Simmons to Pittsburgh where Dr. Simmons succeeded Dr. Henry “Hank” Bahnson as Chair of Surgery. Dr. Bahnson, also a past president of the SUS and renown cardiothoracic surgeon, had built the department almost from scratch and oversaw a department of surgeons notable for their mutual respect, clinical excellence, humility and “can do” ethos. This beloved surgical leader welcomed Drs. Simmons and Billiar with open arms and Dr. Billiar thrived in the house that first “Hank” and then “Dick Simmons” built. Dr. Billiar points out that all of the places he has trained have had no shortage of great role models and mentors, and the same can be said of all the top programs. So, when asked what else might have been the “secrete sauce” of his accelerated success in academic surgery, he says “menteeship”. “I am an excellent mentee. Menteeship is an underappreciated and key aspect of the mentor-mentee relationship.” Dr. Billiar speculates that perhaps emanating from his childhood experiences working in the adult world of healthcare, he learned how to get the most out of as many mentors as he could. He says he still does this, and he finds mentors in institutional leaders, administrators, colleagues and even his students. He also cherishes the opportunity to mentor the great mentees stating, “it is like driving a Ferrari, just touch the gas pedal and hang on”.
My Job is to Clear the Path and Remove the Hurdles
Dr. Billiar has been the Chair of Surgery at the University of Pittsburgh for 25 years and in that time, he has found that one of his main roles has been as talent scout. When it comes to the training, mentorship, and sponsorship of academic surgeons, there is an empirical component, and you need to think a little out of the box. Billiar states, “When I see an exceptional talent, and someone willing to do what it takes, my job is to clear the path and remove the hurdles (not provide shortcuts)”. Also, he feels there is no one size fits all when it comes to strategy, and there is not just one metric for success. A thriving department needs numerous types of talent (e.g., top clinicians, expert educators, effective administrators, and researchers across the spectrum of research disciplines). Nurturing diverse talent means creating opportunities for growth and rewards. Dr. Billiar concludes, “All Chairs know, our job satisfaction comes from the success of the faculty, staff and trainees under our charge and true recognition of success comes only by giving the real credit to others.”
Stay on the Up Escalator
Dr. Billiar feels that he has led a charmed life in academic surgery. He was appointed as Chair of Surgery at less than 7 years out of residency. This means that he bypassed some of the challenges to career progression often faced in academic surgery. In surgery, there is no guarantee that a junior or mid-career faculty will be at a place that will align with one’s vision for themself. However, as UPMC first formed in the 1990’s and then grew to become the nation’s largest academic health system, Dr. Billiar found that the opportunities for personal and career growth kept coming. He now sits on the Executive Committee of the Health System, as Executive Vice President and Chief Scientific Officer. He also plays leadership roles at the University of Pittsburgh but notes that he has never requested any of titles he has received. Instead, he strongly feels that is all about what you get to do when you show up for work, and what value you are adding. When asked by restless faculty about the need to move to move up faster, he points out that if your institution is creating opportunities and allowing growth, do not leave because you may not be able to recreate what you have somewhere else. In Dr. Billiar’s words, “do not get off the up escalator too soon”.
Seeking and Valuing Membership
Dr. Billiar has been the President of the SUS, Surgical Infection Society, the Nitric Oxide Society, and Shock Society, to name just a few leadership positions in professional associations and societies. Dr. Billiar felt that he was lucky and had people ahead of him who understood getting into the SUS early was important for career advancement. He notes that it was in the SUS that he found his peer group, those early and mid-stage career academic surgeons from across the continent who understood the reason we do what we all do and what it takes to succeed. The more senior members were another pool of great mentors. He explained that “there is a point in your career when advancing in societies is important. You learn in the Council rooms and on committees how to group think, address challenges and you make the contacts that are friends for life.” Dr. Billiar’s first SUS meeting was in 1985 when the SUS had a separate conference for residents, and he gave his first talk at the resident forum. He was introduced to Dr. Basil Pruitt, already an icon in academic surgery, in the lobby bar of the hotel and even though he was only a second year resident, Dr. Pruitt showed an interest in his career. That meant a lot to Dr. Billiar and they would become good friends and colleagues for over three decades. Dr. Billiar highly recommends active participation in the SUS starting early in one’s career. Dr. Billiar says, “you will gain the most by actively participating in the meeting and volunteering for committees”. The evolution of the ASC from a concept while Dr. Billiar was President of the SUS to the great success it is today is a testament to what can be accomplished through the coordinated actions of the membership. Dr. Billiar says it has been extremely rewarding to play even a small part of the advancement of academic surgery through participation in the AAS and SUS.
I Sleep Sometimes
It is tradition to ask the Lifetime Achievement Award Winners if they have any interests which may surprise people. First, he pointed out that his life partner for over 30 years, Dr. Edith Tzeng is a highly successful academic surgeon in her own right. He says he is in awe of his wife, noting she puts in more hours than he does, is a great vascular surgeon, a well-funded and productive investigator, an Associate Dean in the school of medicine, and beloved by the students and residents; and oh yes, don’t forget, a wonderful mother to their two kids. Dr. Billiar notes, “Edith and I are a good match, we enable each other’s work-obsessed lifestyles with no regrets”. Keeping up with and supporting their kids is the priority for both. Isabel is a senior in medical school following her mother into vascular surgery, and younger brother Alex is breaking the mold by studying art history and marketing. “More important to both of us, is that they are both great people” Dr. Billiar states. Even with all this talk of career, Dr. Billiar is emphatic that it is important to carve out time for self-care and outside interests. For Dr. Billiar, that comes in the form of regular physical fitness and making time to work with an executive coach. He even took up golf for a while and became “pretty good for someone who picked up the game later in life”. Dr. Billiar likes to collect and restore old photos, and family genealogy is also important. He credits audio books for enabling him to be a voracious reader, he is never without a book and is always on the outlook for the next great read.
Dr. Billiar also pursues his passion for international work through UPMCs International Health Division. He became an expert in the Chinese health system, developed business opportunities in Asia, and developed medical student research training programs between the medical schools at Tsinghua and Xiangya with Pitt. This would earn Dr. Billiar the highest prize bestowed upon foreigners by the Chinese government, the Friendship Award. His work with UPMC International continues to take Dr. Billiar on regular trips to Kazahkstan, Italy and Ireland where UPMC consults on or manages healthcare operations. He is especially excited about his role in supporting the construction of a new 300,000 sq ft research institute in Sicily. Dr. Billiar admits, “Sure, these activities are part of my job responsibilities, but I seek to do this for the cultural and personal growth opportunities and the global perspective that I receive in return”. Dr. Billiar concluded the conversation, “I keep a lot on my plate, but I like it that way, and you know, I sleep sometimes.”
The Society of University Surgeons is honored to present Dr. Timothy Billiar with the 2023 Lifetime Achievement Award at the Academic Surgical Congress on February 6, 2024, taking place in Washington, DC.